Clinical Study of Neonatal Pelvicectasia

OBJECTIVE: This study was conducted to investigate the different cause of pelvicectasia and its clinical outcome. The most important management of pelvicectasia consist of the early diagnosis and evaluation of the pathologic abnormalities of congenital pelvicectasia. This will help to offer the guideline on management of neonatal pelvicectasia. METHODS: We examined one hundred and seventy-one live neonates who were hospitalized and diagnosed with pelvicectasia at Soonchunhyang University Cheonan Hospital from January 2008 to December 2008. A retrospective study was carried out in these patients for last three years. Renal ultrasonography was repeated at 1 month after birth and then 3 months interval. Diuretic renal scan with (99m)Tc-labeled diethylenetriamine pentaacetic acid augmented with furosemide and voiding cystourethrogram was done after 4 to 6 weeks of first renal ultrasonography. Patients were followed-up for 1 to 30 months (average, 7.2 months). RESULTS: Pelvicectasia was postnatally detected in 171 cases (33.7%) among 507 neonates. Males were twice than females. Additional imaging studies revealed that normal kidney structure was the most common postnatal diagnosis (97.1%), followed by ureteropelvic obstruction, vesicoureteral reflux, multicystic kidney, ureteric duplication. Spontaneous regression of pelvicectasia was revealed in 165 renal units (67.6%). CONCLUSION: There are many cause of spontaneous regression in mild to moderate pelvicectasia. Urinary tract infection occurs in many neonates with pelvicectasia. Mild to moderate neonatal pelvicectasia without vesicoureteral reflux is clinically much less significant. Accordingly, close observation with serial renal ultrasonography may be sufficient.

Hydronephrosis due to Ureteropelvic Obstruction in Children: A Review of 18 Cases / 대한비뇨기과학회지

From January 1976 until December 1980 we treated 12 male and 6 female children between the ages of 1 month and 15 years for ureteropelvic obstruction. Diagnosis was based on excretory urography and retrograde pyelography. The male and female ratio was 2:1. The patient in this series were distributed from 1 month old to 15 years old. The obstruction was on the left side in 10 cases, on the right side in 5 and bilateral in 3. Of the patients 7 presented because of an abdominal mass and 6 because of flank pain. The pathologic lesion encountered at ureteropelvic obstruction, are intrinsic ureteropelvic obstruction in 16 aberrant blood vessel in 1 and fibrous band in 2. Dismembered pyeloplasty was done in 10 cases, and nephrectomy in 9 cases. Preliminary nephrostomy was done in 3 cases. And secondary nephrectomy in 1 case. Of the 10 repairs 9 were protected by nephrostomy drainage plus ureteral stent.